Combined pill

Combined contraceptive pill (oestrogen and progestogen) to prevent pregnancy from £10.60.

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Brands of combined pill available

Brevinor

3 x one month pack: £12.50

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Cilest

3 x one month pack: £13.50

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Femodene

3 x one month pack: £13.60

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Eloine

3 x one month pack: £22.00

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Femodene ED

3 x one month pack: £16.50

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Femodette

3 x one month pack: £16.50

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Gedarel 20/150

3 x one month pack: £11.50

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Gedarel 30/150

3 x one month pack: £10.60

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Katya 30/75

3 x one month pack: £16.50

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Levest

3 x one month pack: £11.50

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Loestrin 20

3 x one month pack: £14.50

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Loestrin 30

3 x one month pack: £14.50

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Logynon

3 x one month pack: £15.00

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Logynon ED

3 x one month pack: £15.00

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Lucette

3 x one month pack: £17.00

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Marvelon

3 x one month pack: £13.20

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Mercilon

3 x one month pack: £17.50

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Microgynon 30

3 x one month pack: £13.50

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Microgynon 30 ED

3 x one month pack: £13.50

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Millinette 20/75

3 x one month pack: £12.00

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Millinette 30/75

3 x one month pack: £11.50

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Norimin

3 x one month pack: £12.50

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Norinyl-1

3 x one month pack: £12.50

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Ovranette

3 x one month pack: £12.50

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Qlaira

3 x one month pack: £36.00

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Rigevidon

3 x one month pack: £13.50

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Sunya 20/75

3 x one month pack: £19.00

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Synphase

3 x one month pack: £11.50

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Triadene

3 x one month pack: £22.50

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Triregol

3 x one month pack: £11.50

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Yasmin

3 x one month pack: £24.20

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Zoely

3 x one month pack: £28.80

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About combined contraceptive pills

The combined oral contraceptive pill, also known as The Pill contains the female hormones oestrogen and progesterone, in artificial form.

Combined pills are usually taken for contraception, but can also treat heavy or painful periods, and PMS (premenstrual syndrome) and endometriosis.

The combined pill prevents pregnancy in 3 ways; preventing ovaries from releasing eggs (ovulating), reducing the chances of sperm reaching eggs, and reducing the chances of fertilised eggs implanting in the womb.

Features of the combined pill

• It is 99% effective in preventing pregnancy, if taken correctly. Only one woman in 100 taking the combined pill will become pregnant each year.
• One pill is taken daily for 21 days, followed by a break of 7 days, before restarting. A menstrual bleed normally takes place in the 7 day break.
• ED (extra day) pills come in packs of 28 tablets. 7 tablets in the packs contain no active ingredients. These non-active pills are included to make up the 7 day break as some women may find it easier to not break the routine of taking a daily pill.
• The pill is best taken at the same time each day, and may not work if pills are missed or vomited or in severe diarrhoea.
• Some women on the combined pill experience mood swings, breast tenderness and headaches. See individual patient information leaflets for details of side effects.
• The combined pill is not normally prescribed for women over 35 who smoke, because of the increased thrombosis risk.
• Women taking contraception should have a pill check-up with their surgery GP or nurse, usually 6 monthly.
• It is important that cervical smears are up-to-date.
• Women who are at risk of sexually transmitted diseases should use condoms in addition to their pills.

Choice of pill

There are numerous different brands of combined pills available from different pharmaceutical companies, with differing amounts and types of oestrogen and progesterone. Some pills will contain the same ingredient in every pill (monophasic 21 day pills), others have varying combinations of oestrogen and progesterone through the cycle of 21 pills.

Women, working together with doctors or specialist contraceptive nurses, can usually find a pill which suits them. Dr Fox provides only continuation of existing contraception, not first time contraception or changes to existing contraception.

How to take combined pills

Advice about how to take the pill is usually given by doctor or nurse who first prescribed it. Information can also be found in the patient information leaflet supplied with each pill pack. Most women can start the pill at any time in their cycle, although additional contraception in the first days may be required, depending on where in the cycle the pill was started. Your doctor or specialist nurse can advise. There is also further information at NHS Choices: Contraception guide - Combined pill.

Taking pill packs without a break

Occasionally doctors may advise women to take combined pills without a 7 day pill-free break. This is often done for two or more cycles, and is particularly useful to delay the onset of a period, for example when a woman is planning a holiday. It may also be useful for women who have painful periods. Taking pills without a break should only be done under medical supervision, as it can lead to breakthrough bleeding and some women experience bloating and other side effects.

Missed a pill

If pills are missed, there is an increased risk of pregnancy. The rules about what to do when a pill is missed are complicated. What to do depends on how many pills are missed and where in the cycle. Details can be found at NHS Choices: Contraception guide - Combined pill and our article Missed a Pill? Here's what to do. You can also call NHS 111 or the Sexual Health Line on 0300 123 7123.

If vomiting occurs within two hours, take another pill and the next pill at your usual time.

Is the combined pill suitable?

Dr Fox supplies only 3 months of the oral contraceptive pill at a time, and only to those 18 years to 55 years who already take it.

Most women, who do not smoke, can take the combined pill right up to the menopause. However, not all women take it and regular reviews of contraception are required.

Women who have had a baby and are not breast feeding can start the pill after 21 days. Women who are breast feeding do not normally require contraception, as they are unlikely to become pregnant. Breast feeding has a contraceptive effect, and taking the pill will reduce the flow of milk. The pill can be started 5 days after a miscarriage or abortion.

Some medicines interact with the combined pill and may alter its effectiveness. The rarely prescribed antibiotics rifampicin and rifabutin can make the pill ineffective and stronger pills may be required. Most other antibiotics have a minimal effect, but discuss with a doctor of pharmacist.

The combined pill could possibly very slightly increase the risks of some cancers and reduce the risk of others, more details at NHS Choices: Contraception guide - combined pill

The pill can slightly increase the chance of blood clots, particularly in women who have other risk factors. Checks on suitability will be carried out when the pill is first prescribed at pill checks.

Under 16s requiring contraception should see a doctor or nurse, and this can be without parents being informed, as long there is good understanding and the young person is not vulnerable and in need of protection. More information at the Sexual Health Line on 0300 123 7123.